Left Atrial and Right Atrial Deformation in Patients with Coronary Artery Disease: A Velocity Vector Imaging-Based Study

Abstract

BackgroundImpaired left ventricular (LV) function has been shown by strain rate (SR) imaging in patients with coronary artery disease (CAD). Our aim was to investigate global and regional, systolic and diastolic left atrial (LA) and right atrial (RA) longitudinal deformation in CAD using velocity vector imaging.MethodsEchocardiographic and velocity vector imaging studies were performed in 20 patients with mild CAD, 40 patients with severe CAD and 25 controls. Maximal atrial volume, peak atrial longitudinal strain (εs) and SR during LV systole (SRs), SR during early LV filling (SRe) and late LV filling (SRa) were measured. Longitudinal strain during atrial contraction (εa) was obtained at the onset of P-wave on electrocardiography, and εa/εs was calculated.ResultsLongitudinal peak εs and SRs of LA showed decreased trend among CAD patients. The global and lateral LA SRe were prominently lower, while RA εa, SRa and εa/εs were prominently higher in 2 CAD groups than control group (P value <0.05). As compared with controls and patients with other single-vessel disease, LA SRa and εa/εs ratio were significantly increased among patients with exclusively left anterior descending coronary artery (LAD) stenosis (SRa 1.14±0.38 s−1, 1.10±0.41 s−1, 1.45±0.46 s−1, P value<0.05; εa/εs 0.44±0.11, 0.44±0.20, 0.57±0.12, P value<0.01).ConclusionsApparently decreased SRe of LA and increased εa, SRa and εa/εs of RA were found in CAD patients with preserved LVEF and E/E' in gray zone. SRa and εa/εs of LA were found to significantly increase in those with LAD stenosis.

The association between heart rate variability and biatrial phasic function in arterial hypertension

“…However, recent investigations have demonstrated that RA volume and/or function are important predictors of morbidity and mortality in patients with heart failure, coronary artery disease, pulmonary embolism, or Eisenmenger syndrome. [4][5][6][7] LA phasic function and mechanics have been investigated in arterial hypertension previously, [8][9][10] whereas the data about RA functional remodeling are scarce and mostly provided by our study group. 11,12 Sympathovagal disbalance in systemic hypertension evaluated by heart rate variability (HRV) parameters has been revealed earlier.…”

Right Atrial Geometric Changes in Patients with Proximal versus Distal Significant Right Coronary Artery Stenosis: a Tissue Doppler imaging study

“…This study showed statistically significant difference between group one and the other two groups regarding right atrial free wall strain and strain rate, septal wall strain and strain rate, mean right atrial strain and strain rate.These results were matched with the results of Ping Yan et al who showed significant difference between patients with IHD and control group regarding the RA strain and strain rate. The difference between this study and the study of Ping Yan et al was that we studied the RA strain and strain rate with regard to the site of obstruction of the RCA, while they studied the RA strain and strain rate in ischemic heart disease patients who have mild or severe CAD without relating it to RCA lesion site [18] .…”

Relation Between Left Atrial Strain Function and Coronary Slow Flow Phenomenon Using Two-Dimensional Speckle-Tracking Echocardiography

“…Bununla birlikte strain ve strain rate atriyal dolumdan ve açıdan bağımsızdır. Daha önce yapılan çalışmalarda sol atriyal deformasyon parametrelerinin atriyum hacmi değişmeden daha önce bozulduğu gösterilmiş ve strain ölçümlerenin atriyal dolum parametrelerine kıyas-la daha duyarlı oldukları ortaya konulmuştur (20,21) . Wakami ve arkadaşları tarafından yapılan bir çalışmada sol atriyum pozitif global pik strain değeri ile invaziv olarak ölçülen sol ventrikül diyastol sonu basıncı arasında ters bir ilişki olduğu gösterilmiştir (22) .…”

“…Çalışmaya yaş ortalaması 52 ± 10.4 yıl olan 38 KYA fenomenli hasta (26 erkek, 12 kadın) ve kontrol grubu olarak yaş ortalaması 53 ± 10.6 yıl olan normal koroner arterlere sahip 37 gönüllü (20 Çalışma grubunun konvansiyonel ve doku doppler ekokardiyografik karşılaştırma sonuçları Tablo 2'de gösterilmiştir. Grupların sistolik ve diyastolik fonksiyon parametreleri arasında istatistiksel olarak anlamlı fark tespit edilmedi.…”